Your Rights

Medicaid Recipient Due Process (Appeal) Rights

Right to Appeal Denial of Benefits

If you have been denied benefits and disagree with this decision, you may ask for an appeal. Contact your worker at the Department of Social Services who sent the letter denying benefits.

Right to Appeal Denial of a Specific Service

If a Medicaid health service is denied (or if it is reduced, terminated, or suspended), you will receive a letter by trackable mail. Please sign the required forms to accept delivery of the letter. The letter will come from the N.C. Division of Medical Assistance, or one of its vendors. The vendors are ACS, CSC, The Carolinas Center for Medical Excellence, MedSolutions, the Murdoch Center, ValueOptions, or a behavioral health LME-MCO. The letter describes the decision and why it was made. You have the right to appeal. The letter has instructions for how to appeal.

Medical Care Decisions and Advance Directives

If you are 18 are older, and able to communicate and make health care decisions, you have the right to make decisions about your medical and mental health treatment. The Medical Care Decisions and Advance Directive brochure outlines the steps that you can take to control decisions about your medical and mental health treatment should you become unable to make or express those decisions on your own.